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3a > Psychiatry: Neurodevelopment > Flashcards

Psychiatry: Neurodevelopment Flashcards

1
Q

what is ADHD ? characterised by what ? (3)

A

neurodevelopment disorder characterised by:
- inattention
- hyperactivity
- impulsiveness

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2
Q

how does ADHD often present to health care ?

A

due to poor school performance or sorptive behaviour

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3
Q

describe ADHD symptoms ? characters by the 3 domains

A
  • inattention: difficult maintaining focus on thought/ task, easily distracted, task avoidance, signore instruction, lose things, disorganised, forgetfull
  • Hyperactivity: energetic, difficulty sitting still/ withholding impulsions
  • Impulsiveness: talk excessively, blurt out answers, can’t wait turn, interrupt
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4
Q

ADHD Dx ? requirements ? how long Sx for ? Sx onset ?

A

functionally imparting inattention, hyperacitivy and or impulsiveness (in 2 or more settings) for more than 6 monts
- young at onset (<12 yrs)

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5
Q

first line ADHD managment in children ? second line

A

(6-18)
- stimulant (methylphenidate), psychoeducation, +/- behavioural therapy
- 2nd line: different class of stimulant (amphetamine)

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6
Q

how do stimulants work ind ADHD Mx ?

A

increase dopamine and NAd => improve attention + hyperactivity

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7
Q

SE of ADHD Mx ?

A

methylphendate, amphetamine salts
- SE: growth restriction, appetite suppression, insomnia, addiction

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8
Q

What is ASD ? characterised by what ? (2)

A

neurodevelopemtnal disorder characterised by:
- difficulty in social communication/interaction
- Restricted interest/activites

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9
Q

ASD Dx ?

A

difficulty in social communication + restricted interest/activity present since early childhood => impairing function (exclude other causes)

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10
Q

what are some of the social communication Sx associated with ASD ? difficulty with what ?

A
  • used of language (verbal + non-verbal) difficulties): delayed speech dev (or mute), struggle understanding + using body language/facial expression), only literal
  • difficulty with: reprocity, turn-taking and sharing
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11
Q

describe the restricted/repetitiv pattern associated with ASD ?

A

insistence upon sameness
- same food/activies
- special interest

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12
Q

what other symptoms might there be in ASD ?

A
  • sensory disturabce
  • Savantism
  • reduced cognition (I think)
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13
Q

ASD epi ?

A

0.1-2%
- M>F (x4)

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14
Q

ASD Mx ?

A
  • behavioural therapy
  • speech and language therapy
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15
Q

what is a somatisation or somatiform disorder ?

A

body based/somatic sx (pain, nausea, SOB)
- resemble physical disorder but actually psychological (no pathology)

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16
Q

what is somatic disorder ? Dx ?

A
  • somatic Sx
  • medically unexplained
  • accompanied by maladaptive thoughts + feelings: anxiety, time + energy
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17
Q

name some of the common presentation is somatic disorder ? most common ?

A

pain, fatigue, dizziness, stiffness, palpitations, N+V
- pain is actually experiences (not fake)
- GI tract most common presentation (diarrhoea, vomiting, constipation)
(chronic and impairing)

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18
Q

Somatic Symptom disorder Mx ? (3)

A
  • CBT
  • Mindfullness based therpy
  • Antidepressants
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19
Q

somatisation RF ? (3)

A
  • female
  • sexual or physical assualt
  • ACEs
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20
Q

What is illness anxiety disorder ? associated with what ? describe this

A

obsessional preoccupation that one has a medical disease
- under ocd spectrum: obsessive thought (belief that ill) => impulsive behaviour (check sings + Sx) => distress + dystfuciton => repeat

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21
Q

how illness anxiety disorder different to somatic Sx disorder ?

A

somatic Sx disorder is focus on Sx where illness anxiety is stress is not about the Sx but the disease (will make condition worse when no Dx found)

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22
Q

What is conversion disorder ? aka ? link with what ?

A

functional neurologic disorder
- clinically unexplained abnormality of nervous system brought on by stressful trigger (Sx not faked)
- link with dissociative disorders

23
Q

conversion disorder Px ?

A

similar to somatic Sx disorder however is specifically neuro
- weakness, blindness, numbness, loss of function

24
Q

conversion disorder Mx ?

A

education on disorder (but do not imply that they are lying)

25
Q

name some conditions that present with fake presenting complaints ?

A
  • factitious disorder
  • malingering
26
Q

what is factitious disorder ?

A

(munchhausens)
- fabricated to gain social benefits associated with the sick role (sympathy)

27
Q

what is malingering ?

A

fabricated presentation to gain some external reward (liability benefits, stay in hospital)

28
Q

What is Body dysmorphia ? associated with what condition ?

A

Mental fixation that specific aspects of ones appearance are flawed/deformed
- OCD spectrum disorder

29
Q

describe some of the features of body dimorphic thinking ?

A

entirely based on perception + not on what objective outsider would think
- Ego-syntoinic, disabiling

30
Q

how is body dysmorphia like OCD ?

A

obsessions: intrusive, mid based, unwanted, resistant, distressing, recurrent
- compulsions: measuring, weighing, body checking
- leading to distress + dysfunction

31
Q

Body dysmorphia Mx ?

A

same as OCD: CBT, consider SSRI

32
Q

what are eating disorders ? generally, causing ?

A

pattern of abnormal food intake that decreases someones ability to maintain adequate nutrition => physical + psychological health disorders

33
Q

what do anorexia and bulimia have in common ?

A

overvalue beliefs about weight + maladaptive behaviours

34
Q

what is anorexia nervosa ? characterised by ?

A

perceive to be overweight despite being underweight (often use BM < 17.5)
- nervous about gaining weight (constant preoccupation)
- distorted perception (body dysmorphia)
- excessive exercise (+use of laxatives)
- restricting calories
(similar to OCD thinking again)

35
Q

what are some of the physical manifestations of anorexia ? (9)

A
  • fatigue
  • amenorrhoea
  • osteoporosis
  • cardiac arhythmias (hypokalaemia)
  • lanugo hair
  • hypotension
  • reduced temp
  • mood changes
  • cold
36
Q

anorexia Epi ? M:F ? mortality ?

A

<0.5%
F>M (x20)
20% mortality

37
Q

wha Is bulimia nervosa ? characterised by what ?

A
  • binge eating: eating v large amounts with no control, emotional numbness during eating, disgust post-eating
  • offsetting/purging (self induced vomiting)
  • linked to self esteem
38
Q

what personality disorder is bulimia linked to ? anorexia ?

A

anorexia: OCPD
bulimia: BPD

39
Q

what are some of the effects of self induced vomiting (signs+sympotms) ?

A
  • erosion of dental enamel
  • swollen salivary glands
  • injury on back of knuckles (Russell sign)
  • Kidney disease from dehydration
  • gastric ulcers
40
Q

what blood gas associated with bulimia ?

A

metabolic alkalosis

41
Q

bulimia Mx ? don’t use what ?

A

CBT + SSRIs
- do not use bupropion ! (increases risk of siezures)

42
Q

What is binge eating disorder ? often triggered by what ? associated with what ?

A

similar to bulimia but not offset by purging => often overweight
- associated with BPD
- often overeat due to underlying psychological distress

43
Q

what is ARFID ?

A

avoidant/restrictive food intake disorder (ARFID): tend to avoid food/ narrow selection => failure of adequate nutrition (not related to body image)

44
Q

what is referring syndrome ? who at risk more ? (2)

A

occurs in Px who have been in severe nutritional defect for an extended period and then resume feeding
- Px at higher risk: BMI < 20, little toe at for past 5 days
(risk increases with lower BMI and more days without eating)

45
Q

describe the pathophys of refeeding syndrome ?

A

cell metabolism slows during prolonged malnutrition => feed => starved cells process glucose + protein + fats => electrolyte abnormalities

46
Q

what electrolyse abnormalities are there in referring ? (3) risk of what ? (3)

A
  • hypomagnesia
  • hypokalaemia
  • hypophosphataemia
    risk of: cardiac arrhythmias, fluid imbalances, heart failure
47
Q

refeeding syndrome Mx ?

A
  • slowly reindorodece food + restrict calories
  • MG, K, Pohs + glucose monitoring
  • fluid balance monitoring
  • ECG monitoring
  • Supplementation (B vits, Thiamine)
48
Q

What is adjustment disorder ?

A

depressive and/or anxious sx that occur after major life stressors (divorce, lose job)
- often subsyndromal depression (<5/9)

49
Q

adjustment disorder Mx ?

A

supportive therapy

50
Q

what is catatonia ?

A

abnormal mental state characterised by changes in consciousness + behaviour

51
Q

catatonia presentaiton ?

A
  • lethargy (sedated despite eyes open)
  • immobility (lack of movement => malnutrition + dehydration)
  • mutism (absent verbal communication)
  • positioning (holding abnormal positions)
  • echolalia, echopraxia
52
Q

what conditions is catatonia associated with ?

A
  • BP
  • MDD
  • schizophrenia
53
Q

catatonia Mx ? (3) gold standard

A
  • benzos
  • ECT (gold standard but start with benzos as less invasive)
  • discontinue AP

3a (43 decks)

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